Pharmaceutical care on an atrial fibrillation patient with abnormal fluctuations of INR when taking warfarin
ZHANG Jin-ping
XU Hong
Abstract：A 78-year-old man had a history of long-term oral use of warfarin for the treatment of atrial ifbrillation, with INR ranging between 1.6 and 2.5. The patient stopped taking warfarin for PT 41.6 s and INR 3.53 when hospitalized. Four days later, warfarin was restarted when INR was 1.25. He took celecoxib for arthralgia, and soon the PT and INR increased from 14.4 s and 1.25 to 36.7 s and 3.12, respectively. The clinical pharmacists analyzed that loratadine and celecoxib could increase the anticoagulation of warfarin, and advised that warfarin should be stopped, while vitamin K1 should be used. The coagulation indicators such as INR and bleeding were monitored more intensely. Warfarin was given again after INR decreased to normal. The patient did not suffer from bleeding and thromboembolism during the hospitalization.
Keywords：WarfarinINRAtrial ifbrillationPharmaceutical careClinical pharmacist
Publication Date：2013-01-01
Online Publishing Date：2025-08-15(First online date of this platform, not the publication date of the document)
Pages：3( 271-273 )